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Take a look at a selection of our recent media coverage:

Wireless technology trials at seven NHS trusts aim to demonstrate best practice

16th February 2024

Wireless technologies aiming to help free up staff time, strengthen connectivity in emergency departments and ambulance bays and improve patient care are being trialled across seven NHS trusts.

Part of NHS England’s Wireless Trials programme, the trials aim to provide organisations with the capability they need to deliver the challenging digital ambitions set out in the NHS Long Term Plan.

Each of the seven trusts involved will benefit from a share of NHS England’s £1 million funding, as well as advice and guidance and the opportunity to collaborate with like-minded organisations, NHS England said.

Examples of best practice from successful trial sites will also be captured and shared across the wider NHS, it added.

Supporting key initiatives for staff

One of the triallists is Manchester University NHS Foundation Trust, which will trial an innovative approach of combining satellite and cloud-based wireless solutions to enhance connectivity across its 10 hospital sites and wider community services.

Commenting on their plans, Dan Prescott, group chief information officer at Manchester University NHS Foundation Trust, said: ‘As one of the country’s largest NHS trusts, it’s essential that we can provide continuous patient care with minimum disruptions. With the Wireless Trial we’re aiming to create a reliable, fast and secure network access solution to address unexpected connectivity issues, even in areas of poor-connectivity.

‘This is vital in supporting key initiatives for our staff and giving our patients the best possible care.’

Real-time monitoring

Mid Cheshire Hospitals NHS Foundation Trust will use the funding to install wireless trackers on medical equipment and hospital beds, which allow real-time monitoring and location tracking so that staff can easily find what they need, when they need it. The trial is expected to be completed by summer 2024.

Dylan Williams, chief information officer at Mid Cheshire Hospitals, said: ‘Piloting this cutting-edge technology is an exciting opportunity for us as we drive forwards with the creation of a new Leighton Hospital Campus in Cheshire.

‘At our Trust, the money will fund an innovative project that tracks medical equipment at our hospitals. Initially, we’ll trial it on infusion pumps. This will support efficient maintenance of the equipment and ensure clinical staff can quickly and easily locate the pumps when needed.

‘One of our key ambitions for the New Hospital Programme is to embrace digital technology and the benefits it can bring for our patients and staff. Trialling this project now allows us to make significant progress with one of the advancements that we can expect to be commonplace at Mid Cheshire Hospitals in the future.’

The Princess Alexandra Hospital NHS Trust will also install wireless trackers on medical equipment and hospital beds in a similar trial.

Boosting efficiency with wireless technology

Another project run by Sussex Community NHS Foundation Trust will introduce a new app that allows staff to take observations on tablets and smartphones by patients’ bedsides, reducing the time spent typing up patient notes and freeing up more time to spend with patients.

A trial at the Countess of Chester NHS Foundation Trust will wirelessly link modern diagnostic devices with the trust’s electronic patient records system, speeding up assessment time for patients.

Both the North West and the East of England ambulance services trusts will roll out improved wireless connections in A&E and ambulance areas, ensure faster transfer of essential patient care data from ambulances to hospitals.

Commenting on the new trials, Stephen Koch, executive director of platforms at NHS England, said: ‘I have been impressed with the innovative ideas coming from the system and we are delighted to be able to award this funding to the successful trialists to develop new or improved wireless solutions for the NHS.

‘We’ll be monitoring the outcomes of the trials and are very hopeful that a number of these will be able to be scaled more broadly across the health and social care system saving clinical time, improving patient care and saving money for the system.’

Previous wireless trials included the development of the ‘Find and Treat‘ service at University College London Hospitals. This uses high-tech tools and software to provide real-time remote diagnosis and referrals on board a mobile health unit to support vulnerable, homeless, and high-risk people in the city.

Another trial led to South London and Maudsley NHS Foundation Trust becoming the first 5G-connected hospital in the UK.

Applications for the next series of wireless trials will open later in 2024.

Need for patient education on AI in healthcare to build trust revealed in new survey

9th October 2023

Almost two thirds of patients are comfortable with using healthcare settings that use artificial intelligence (AI), but only if they are familiar with the technology, according to a new survey from GlobalData.

The results revealed that 60% of patients who were familiar with AI were either very or quite comfortable with attending an AI-enabled healthcare setting. When it came to people who weren’t familiar with the technology, this level of comfort fell to just 7% of patients.

A lack of in-person interaction was the top patient concern associated with physicians using AI in clinical practice, and most patients felt more comfortable with physicians using it to automate administrative tasks compared to directing patient care.

Faster healthcare delivery and mitigation of healthcare staff shortages were identified as the main benefits associated with AI use in clinical practice.

The survey data also reveals that those aged 18-55 years were more likely to be familiar with AI than those aged 56 years and over, with more than 50% of the younger group rating their knowledge as moderately or very familiar.

Commenting on the important and evolving use of AI to detect image-based diseases such as cancer, Urte Jakimaviciute, senior director of market research at GlobalData, said: ‘Together with the development of a robust regulatory framework, it is imperative to prioritise patient education regarding the technology.

‘This education should aim to enhance comprehension of AI’s utilisation, its potential advantages, and associated adoption risks, ultimately fostering increased trust in AI. Enhanced knowledge empowers individuals to make informed decisions and mitigate biases linked to this technology.’

Similar issues around trust have been identified in previous studies. For example, a 2021 study looking at patient apprehensions about the use of AI in healthcare, published in the journal NPJ Digital Medicine, identified concerns relating to its safety, threats to patient choice, potential increases in healthcare costs, data-source bias and data security.

These authors also concluded that ‘patient acceptance of AI is contingent on mitigating these possible harms’.

The new GlobalData survey, Thematic Intelligence: AI in Clinical Practice – Patient Perspective 2023, saw 574 patient respondents from the US, France, Germany, Italy, Spain, the UK, Japan, Brazil, Canada, India and Mexico.

The patients were diagnosed with conditions such as heart diseases, diabetes, multiple sclerosis, cancer, chronic respiratory conditions, rheumatoid arthritis, psoriasis and inflammatory bowel disease. They were surveyed between July and August 2023.

Virtual wards held back by lack of public understanding, research suggests

1st August 2023

A lack of understanding of what virtual wards actually are ‘may be holding back’ progress and uptake of the model in the UK, despite evidence of the public being largely supportive of the concept, researchers have suggested.

According to a survey led by The Health Foundation, 45% of the UK public is ‘very‘ or ‘quite‘ supportive of virtual wards, with over a third (36%) saying they were ‘not very‘ or ‘not at all‘ supportive. Some 19% responded that they didn’t know.

However, when asked if they would be happy to monitor their own health at home using technologies, instead of in a hospital – a similar scenario that avoided the term ‘virtual ward’ – support shot up to as many as four in five (78%), compared to just 13% rejecting the idea.

This indicated that a lack of knowledge about virtual wards was ‘stymying support for the policy’, risking slowing the uptake for the model of care, The Health Foundation said.

NHS England is aiming to introduce more than 10,000 virtual ward beds ahead of this winter, including an announcement last month to expand the services to cover children’s care.

Current NHS England guidance is also driving the digitisation of virtual wards, with plans to enhance them through the use of technologies, such as remote monitoring. Similar commitments are also in place in Scotland, Wales and Northern Ireland.

The Health Foundation’s research also found that:

  • Support for virtual wards varied on how much one knew about how the NHS uses technology, with those who knew a ‘great deal’ (69%) being more on board that those who didn’t (24%)
  • Disabled people (50%), people with a carer (58%) and carers (55%) were more likely to support virtual wards than the population as a whole (45%)
  • Older people were more open to using virtual wards under the ‘right conditions’, with only 21% of those over 65 saying they would not want to use one compared to 36% of 16-24 year olds.

The research also included 1,251 NHS staff. Of these, almost two thirds (63%) were either ‘very‘ or ‘quite‘ supportive of virtual wards, while 31% were ‘not very‘ or ‘not at all‘ supportive. When asked what will matter for making sure virtual wards work well, their top two factors were the ability to admit people to hospital quickly if their condition changes, and the ability for people to talk to a health professional if they need help.

Director of innovation and improvement at The Health Foundation, Dr Malte Gerhold, said: ‘It is encouraging to see support for virtual wards is higher among those more likely to require healthcare, such as older people, disabled people and those with a carer. As virtual wards are rolled out, the NHS will need to consider the barriers that households can face and make sure they have the right support available.

‘In the face of unprecedented pressures, the NHS won’t be sustainable in future without greater use of new technologies, so ensuring new ways of delivering care have the backing of patients and the public will be critical if they are to become part of business-as-usual. As well as evaluating virtual wards to ensure they are delivering high-quality care in practice, policymakers need to engage more with the public about how to maximise the potential of better tech-enabled care at home.’

A version of this article was originally published by our sister publication Healthcare Leader.

Surgeons lose one working month a year due to outdated technology, study finds

26th July 2023

Surgeons in the UK lose an average of four working hours a week – equal to one working month a year – due to inefficient technology, according to a new survey by Censuswide on behalf of Medtronic.

The ‘State of Surgery in the UK’ survey explored surgeons’ attitudes towards the technologies they use in their role, the efficiency of them and the degree to which they enhance or hinder performance.

Some 79% of the 300 respondents said surgical care would be easier to deliver if technology was improved, and 58% agreed that technology in the operating room is inefficient and could impact the delivery of patient care.

In addition, 54% of surgeons reported spending time outside of hospital hours on administration that could be automated, and 56% of surgeons agreed time spent on administrative and logistical tasks could be reduced with better technology, which could free them up to focus on upskilling themselves and their team in other areas.

Commenting on the findings, Professor Sanjay Purkayastha, consultant upper GI and bariatric surgeon at Imperial College, NHS Healthcare Trust, and honorary professor at Brunel University, said: ‘The survey results reflect a challenge that many of us in the surgical community know all too well. For many surgeons, the lack of adequate technological support throughout the patient pathway leaves the surgical team perpetually short on time. Time that could be used on crucial analysis and training. An upgrade in the technologies available to surgeons is long overdue.

‘The enhanced efficiency and accuracy we gain from a more integrated and intelligent operating room are undeniable. In surgery, the benefits of being proactive, rather than reactive, are critical to maintaining a high quality of care. Digital technologies will be key to sustaining this. Unfortunately, these benefits remain out of reach for far too many in our field.’

Professor Naeem Soomro, consultant urological surgeon at Newcastle’s Freeman Hospital and Royal College of Surgeons Council member, added: ‘These findings validate and mirror our own research highlighting that the future of surgery lies in more forward-facing digital solutions. Robotics, data and artificial intelligence will allow the NHS to respond to current challenges around access, safety and sustainability of healthcare.’

The future of robotic assisted surgery

This comes as the Royal College of Surgeons of England published a new guide covering some of the challenges – such as accessibility, variable outcomes and possible patient harm – and benefits of robotic surgery, including greater precision, freeing up hospital beds and improving patient recovery.

The guide, ‘Robotic assisted surgery: A pathway to the future’, also looks at the potential future application of robotics and makes recommendations to encourage sound governance practices that can lead to the safe adoption and expansion of robotic surgery in UK hospitals.

It proposes a structured pathway for established surgeons who want to transition to robotic-assisted surgery and identifies the relevant roles and responsibilities of key stakeholders for ensuring and maintaining safe autonomous practice in robotic surgery.

Nuha Yassin, consultant colorectal surgeon, robotics and minimally invasive surgery and RCS England Council lead for the future of surgery, robotics and digital surgery, said: ‘This timely new guidance will support the safe and structured introduction of robotic assisted surgery – and the fruitful collaboration between hospitals, surgeons and industry. It’s important for the surgical profession, led by RCS England, in collaboration with the surgical speciality associations, to take charge of all processes, accredit training centres and pathways and facilitate equity in access and training.

‘To benefit from the potential advantages, any investment in purchasing robots needs to be accompanied by proper planning for its introduction into the service with a focus on training, quality assurance and efficiency. This also needs to acknowledge the variable learning curve which can be long for some surgeons and theatre teams before these efficiencies can be observed at a large scale.’

Prominent cardiologist Dr Andrew Coats to speak at HHE event

21st April 2023

Hospital Healthcare Europe is delighted to welcome cardiologist Dr Andrew Coats as an advisory board member and speaker at the upcoming Clinical Excellence in Cardiovascular Care event on 10 May 2023.

Dr Coats, Scientific Director and CEO at Sydney’s Heart Research Institute, will chair a panel discussion on the use and misuse of modern technology in the treatment of the heart. He will be joined by consultant cardiologists Matthew Kahn and Jennifer Peal from Liverpool Heart and Chest Hospital and Newcastle’s Freeman Hospital, respectively.

This inaugural event in HHE’s Clinical Excellence series brings together renowned experts from recognised Centres of Excellence to share best practice and explore the latest advances in cardiovascular care from heart failure to interventional cardiology.

Providing the opportunity to gain CPD hours, the day-long event will also focus on how to best use multidisciplinary teams and improve patient care in this area. The agenda has been created by HHE with the support of four advisory board members to offer cardiologists and members of the multidisciplinary team a comprehensive overview of this broad clinical area.

Cardiology content

To coincide with the event, a new Clinical Excellence section has been added to the HHE website with a whole host of additional content and interviews with prominent cardiologists from Centres of Excellence and beyond. This includes a fascinating interview with Dr Coats, who is also editor-in-chief of the Cardiac Failure Review journal. HHE spoke to him about his career in cardiology, and heart failure in particular, as well as his pioneering approach to optimising and achieving excellence in patient care.

Find out more about Clinical Excellence in Cardiovascular Care, including the timings and agenda, and register for free, here.

Further events in HHE’s Clinical Excellence series will be announced soon, with respiratory coming first in the summer of 2023.

Heart of the matter: the increasing role of technology in heart care

13th April 2023

Vince Walker

Vince Walker has worked at the Royal Stoke Hospital for 14 years and is currently head of cardiac arrhythmia diagnostics and electrophysiology.

Training as a cardiac physiologist in 2009, Vince Walker has a particular interest in technology in heart care and has since completed a postgraduate accreditation with the British Heart Rhythm Society (BHRS) and the International Board of Heart Rhythm Examiners (IBHRE) for both cardiac devices and cardiac electrophysiology.

Walker is passionate about using technology within the NHS to help manage patients with detectable conditions, such as atrial fibrillation (AF), to deliver “cost-effective, accurate and swift diagnostics to patients”.

He shares how he helped evolve the stroke care pathway at his hospital and why tech and diagnostics are the future of healthcare.

Why is managing patients with detectable conditions, such as AF, so important?

The link between AF and stroke is established but not fully understood. The immediate and long-term effects of a stroke on an individual, their family and the NHS is significant. It is fiscally costly to treat and manage a patient following an embolic stroke and, more importantly, the personal cost to an individual patient is often devastating. However, there is a general acceptance that AF-related stroke is largely preventable with prolonged cardiac monitoring to detect AF and anticoagulation therapy.

Looking at technology in heart care, you helped evolve the stroke care pathway at your hospital. Please can you tell us more about it?

I worked closely with Dr Indira Natarajan and Rachel Powell in neurology stroke services to develop a pathway for post-TIA/stroke patients to access implantable cardiac monitors as an option to help to detect AF after cryptogenic stroke. In the wider stroke population, conventional arrhythmia diagnostics using ambulatory monitoring fails to reveal a high incidence of AF and cannot rule out paroxysmal AF as a risk factor for stroke. This equates to approximately 25% of referrals into the arrhythmia monitoring service.

A small pilot study at the Royal Stoke Hospital comparing 50 post-stroke patients inserted with the device to a post-stroke cohort fitted with conventionally ambulatory monitors (observed retrospectively over six months) was found to have considerably different diagnostic yields to detect AF (15% vs <1%). This led to the development of our direct access service and the use of these insertable heart monitors in the most appropriate post-stroke patients.

What advantages did this bring?

It led to expedited diagnosis of AF and intervention with anticoagulation compared to traditional follow-up methods. Waiting times are often shorter for device implantation compared to ambulatory monitoring.

The pathway extends to patients that have made a good recovery post-stroke and would be considered for anticoagulation if AF was detected. There is also the additional therapeutic value in patients diagnosed with AF; it may be the case that symptoms related to the rate of arrhythmia occur as events become more frequent. We are currently observing patients with detected AF and their long-term outcomes following treatment with respect to drug therapy, ablation or even pacemaker therapy.

How were patients managed before the introduction of this pathway?

Post-stroke patients would be referred for 24-hour ambulatory or Holter cardiac monitoring. This would be performed approximately six weeks later in an outpatient clinic. The results of the monitors would generally be reported back to the stroke team within seven days. If AF was not detected it would be typical to offer longer-term monitoring of up to seven days, but this would often require a further waiting time of six weeks or longer. Essentially, referrals for prolonged cardiac monitoring may typically require several months of waiting and still be very unlikely to diagnose AF.

Has this approach led to cost savings?

The cost savings are difficult to appreciate through secondary care budgets. The stroke physicians believe the biggest cost saving is through the reduction of AF-related stroke by means of anticoagulation, better patient outcomes and lesser stroke severity, which, if reduced, may show more of a cost saving in the social care sectors. In a related study, the approach led to a 64% reduction in risk of stroke and a 25% reduction in mortality. Regrettably, this pathway is geared toward patients who have already transited secondary care treatment for which the initial cost has already been incurred. The evidence for device-detected AF, anticoagulation and relative stroke risk reduction is currently unclear, but, by developing pathways, we hope trends will emerge to further these pathways in the future.

How did you develop your expertise in this area? 

I spent two years [2015-2017] working to consolidate the more technical aspects of cardiac devices and to really understand the potential and limitations of device care with patients. I now lead a large cardiac rhythm management (CRM) diagnostics service at University Hospitals of North Midlands NHS Trust (UHNM) that delivers approximately 1,200 conventional ambulatory ECG monitors and 50 insertable devices per month through a team of 15 specialist arrhythmia physiologists and clinical scientists.

What does a typical day look like for you?

Typically, I work an 8am to 5pm day with a one-in-seven on-call out-of-hours and overnight. I hold a clinical role within cardiac devices and electrophysiology covering outpatient clinics and procedures undertaken in the cardiac catheterisation lab. In addition, I am the service lead for electrophysiology and cardiac rhythm management and lead a large team to deliver a nationally recognised service. I would not be in this position without such a motivated, enthusiastic and hardworking team aligned to the same goal.

How is your hospital set up for cardiology medicine?

Roles range from Band 2 technicians with a primary focus on the delivery of ambulatory monitors and 12-lead ECG in outpatient settings and on the front line in A&E to coordinate flow through other outpatient clinics such as echocardiography. Band 3 and 4 staff complete a similar role but with more responsibility and independence, often working out in the community where specialist support is not readily available. 

Then Band 5 cardiac physiologists provide the majority of the more complicated tests, such as exercise tolerance tests, and are involved in cardiac catheterisation labs and the reporting of ECG data. Band 6 roles take on further responsibility within arrhythmia monitoring and are considered entry-level positions in postgraduate training opportunities within echocardiography or cardiac devices. 

Finally, Band 7 members of staff are qualified within those advanced practice roles to provide the more complex tests and reports to diagnose or contribute to the diagnosis of cardiac conditions.

What procedures or treatments are carried out most frequently?

On a weekly basis, UHNM NHS Trust’s cardiac diagnostics department provides more than 500 echocardiograms, over 300 ambulatory monitors, more than 300 ECGs, 500 insertable transmissions and in excess of 500 pacemaker/defibrillator appointments.

The wider team comprises nearly 70 staff delivering 2,000 patient interactions per week. Organising this many investigations is challenging given the flexibility of the NHS, the time sensitivity required for certain inpatient tests and the reactive nature of the environment due to emergencies or higher priority activity with no notice.

Does your institution have any preceptorship or training programmes for clinicians in cardiac medicine?

Within the cardiac physiology and healthcare science team at UHNM, preceptorship is offered to newly qualified Band 5 staff to help consolidate knowledge, to motivate and inspire, and to provide exposure to staff into the three advanced areas of practice: echocardiography, device management and cardiac arrhythmia management.

Are you currently working on any research projects?

Yes – with respect to the pathway and outcomes of MRI in patients with non-conditional cardiac devices. These are patients fitted with either pacemakers or defibrillators, who are considered unsafe to undergo MRIs. By following a risk-stratified MDT approach with cardiology, radiologists and physicists are actually safe to continue to MRI. Having a structured pathway may enable legacy device patients or those currently contraindicated to safely undergo MRI in certain conditions. We have submitted this strategy to publication and international conferences. 

Another publication awaiting peer review is an observational piece that considers the safety and efficacy outcomes following MDT for cardiac device patients undergoing radiotherapy for the treatment of cancer.

We are also currently looking into why patients decline implantable cardioverter defibrillator (ICD) devices. We are also exploring a ‘One Hospital Care’ solution to help collect information to easily identify trends within services and pathways to improve current service provision or what we may need to alter and steer towards in the future.

What does the future of healthcare look like?

I feel the largest changes in the area of cardiac arrhythmia management will be more related to the management of large amounts of data produced routinely by patients 24 hours a day, seven days a week.

Explore the latest advances in clinical care, delivered by renowned experts from recognised Centres of Excellence, at the HHE Clinical Excellence in Cardiovascular Care event on 10 May 2023. Find out more and register for free here.

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